Article ; Online: INR and COVID-19 severity and mortality: A systematic review with meta-analysis and meta-regression.
2021 Volume 66, Issue 2, Page(s) 372–380
Abstract: ... We conducted a systematic review and meta-analysis of the INR in COVID-19.: Methods: A literature search was ... reporting INR values, measures of COVID-19 severity, and mortality (PROSPERO registration number ... with COVID-19 severity and mortality. Both INR prolongation and D-dimer elevations can be useful ...
| Abstract | Objectives: D-dimer elevations, suggesting a pro-thrombotic state and coagulopathy, predict adverse outcomes in coronavirus disease 2019 (COVID-19). However, the clinical significance of other coagulation markers, particularly the international normalized ratio (INR), is not well established. We conducted a systematic review and meta-analysis of the INR in COVID-19. Methods: A literature search was conducted in PubMed, Web of Science and Scopus, between January 2020 and February 2021, for studies reporting INR values, measures of COVID-19 severity, and mortality (PROSPERO registration number: CRD42021241468). Results: Thirty-eight studies in 7440 COVID-19 patients with low disease severity or survivor status during follow up (50 % males, mean age 57 years) and 2331 with high severity or non-survivor status (60 % males, mean age 69 years) were identified. The INR was significantly prolonged in patients with severe disease or non-survivor status than in patients with mild disease or survivor status (standard mean difference, SMD, 0.60; 95 % confidence interval, CI 0.42 to 0.77; p < 0.001). There was extreme between-study heterogeneity (I Conclusions: Prolonged INR values were significantly associated with COVID-19 severity and mortality. Both INR prolongation and D-dimer elevations can be useful in diagnosing COVID-19-associated coagulopathy and predicting clinical outcomes. |
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| MeSH term(s) | COVID-19/blood ; COVID-19/complications ; COVID-19/diagnosis ; COVID-19/mortality ; Fibrin Fibrinogen Degradation Products/analysis ; Humans ; International Normalized Ratio/methods ; International Normalized Ratio/statistics & numerical data ; Mortality ; SARS-CoV-2 ; Severity of Illness Index ; Thrombophilia/blood ; Thrombophilia/diagnosis ; Thrombophilia/etiology | |||||
| Chemical Substances | Fibrin Fibrinogen Degradation Products ; fibrin fragment D | |||||
| Language | English | |||||
| Publishing date | 2021-07-21 | |||||
| Publishing country | Netherlands | |||||
| Document type | Journal Article ; Meta-Analysis ; Systematic Review | |||||
| ZDB-ID | 2273668-2 | |||||
| ISSN | 1898-4002 ; 1896-1126 | |||||
| ISSN (online) | 1898-4002 | |||||
| ISSN | 1896-1126 | |||||
| DOI | 10.1016/j.advms.2021.07.009 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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